Variations in Chronic Obstructive Pulmonary Disease Outpatient Care in Respiratory Clinics: Results From the 2021 EPOCONSUL Audit

• Myriam Calle Rubio ^[1] ; José Luis López-Campos ^[3] ; Marc Miravitlles ^[4] ; Juan José Soler Cataluña ^[5] ; Bernardino Alcázar Navarrete ^[6] ; Manuel E. Fuentes Ferrer ^[2] ; Juan Luis Rodríguez Hermosa ^[1]
  1. [1] Hospital Clínico San Carlos de Madrid

     Hospital Clínico San Carlos de Madrid

     Madrid, España

     
  2. [2] Hospital Universitario Nuestra Señora de Candelaria

     Hospital Universitario Nuestra Señora de Candelaria

     Santa Cruz de Tenerife, España

     
  3. [3] Respiratory Disease Medical-Surgical Unit, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Spain
  4. [4] Pulmonology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
  5. [5] Pulmonology Department, Hospital Arnau de Vilanova-Lliria, Valencia, Spain
  6. [6] Pulmonology Department, Hospital Virgen de las Nieves, Granada, Spain

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 59, Nº. 5, 2023, págs. 295-304
• Idioma: inglés
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  • Introduction The aim of our work has been to describe the results of the clinical audit carried out in 2021 and to compare the results with 2015 EPOCONSUL audit.

    Methods EPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care provided to patients with a diagnosis of chronic obstructive pulmonary disease (COPD) in respiratory clinics in Spain with prospective recruitment between April 15, 2021, and January 31, 2022.

    Results A total of 45 hospitals participated in the 2021 audit and 4.225 clinical records of patients were evaluated. Clinical phenotype according to the Spanish National Guidelines for COPD care (GesEPOC) was reported in 63.1% of the audited patients, and the COPD type assessment for the Global initiative for chronic Obstructive Lung Disease (GOLD) was present in 38.3%. There was an improved compliance with clinical practice guideline (CPG) recommendations in the 2021 audit with respect to the 2015 audit. There was an increase in the proportion of cases with alfa-1-antitrypsin serum level testing available (audit 1: 18.9%; audit 2: 38.7%, p < 0.001) and 6-min walk test carried out (audit 1: 24%; audit 2: 45.2%, p < 0.001). However, these significant variations adherence to CPG recommendations were not reached for the clinical evaluation and therapeutic intervention category when adjusting for patient and resource variables.

    Conclusions The 2021 EPOCONSUL audit showed increased adherence to recommendations although they seem to be related to the availability of resources for care. These results should be taken into account in order to establish improvements in resources to achieve a better quality of care.